Cryotherapy as an adjunct to systemic antimonials for cutaneous leishmaniasis in children

Abstract

765 References1 Kragballe K, Beck HI, Sogaard H. Improvement of psoriasis by a topical vitamin D3 analogue (MC903) in a double-blind study. Br J Dermatol 1988; 119: 223 -230. 2 Dubertret L, Wallach D, Souteyrand P et al. Efficacy and safety of calcipotriol (MC903) ointment in psoriasis vulgaris. A randomised, double-blind, right/ left comparative, vehicle-controlled study. J Am Acad Dermatol 1992; 27: 983-988. 3 Ashcroft M, Li Wan Po A, Williams HC, Griffiths CEM. Systematic review of comparative efficacy and tolerability of calcipotriol in treating chronic plaque psoriasis. Br Med J 2000; 320: 963 -967. 4 Bourke JF et al. Occlusion enhances the efficacy of topical calcipotriol in the treatment of psoriasis vulgaris. Clin Exp Dermatol 1993; 18: 504 -506. 5 Holick MF, Pochi P, Bhawan J. Topically applied and orally administered 1,25-dihydroxyvitamin D 3 is a novel safe and effective therapy for the treatment of psoriasis: a three year experience with histologic analysis. J Invest Dermatol 1989; 92: 446. 6 Kato T, Rokugo M, Terui T, Tagami H. Successful treatment of psoriasis with topical application of the active vitamin D 3 analogue 1α,24-dihydroxycholecalciferol. Br J Dermatol 1986; 115: 431-433. 7 Raymond GP. Hydrocolloid dermatological patch over a corticosteroid cream in treatment of psoriasis. Curr Ther Res 1989; 5: 767-774. 8 Fry L, Almeyda J, McMinn R. Effect of plastic occlusive dressing on psoriatic epidermis. Br J Dermatol 1970; 82: 458 -462. 9 Fisher LB, Maibach HI. Physical occlusion controlling epidermal mitosis. J Invest Dermatol 1972; 59: 106-108. 10 Marriot C, Martin GP. Preclinical results of a new hydrocolloid patch used in conjunction with topical corticosteroids in inducing the blanching response. In: Ryan TH, ed. Beyond Occlusion Dermatology Proceeding. Royal

Efficacy of a weekly cryotherapy regimen to treat Leishmania major cutaneous leishmaniasis

“…Good cosmetic results after cryotherapy were described by previous investigators. 20,22,23,29 The accelerated healing process achieved through cryotherapy-as our efficacy results indicate-may be responsible for the low scarring rate. However, the clinical status of the lesion before treatment seems also to affect the extent of scarring.…”

“…Previous investigators have also found that color change due to cryotherapy was a transient side effect that resolves within months. 11,20,25,29 Although it is difficult to find a well-standardized scale for the assessment of scar quality in cases of CL, in general terms, scarring after cryotherapy was negligible in the majority (93.6%) of lesions. When noticeable, the scarring was not exaggerated and not beyond that which may occur after self-healing.…”

“…Several approaches are available for the treatment of CL, as recently reviewed. 22,29,30 These include the chemotherapy as systemic, intralesional, and topical in form and natural treatments, such as cryotherapy, heat, carbon dioxide laser, and surgical excision. In addition to the dangerous side effects 19,31 of first-and second-line drugs (pentavalent antimony, and amphotericin B, respectively), these drugs require repeated parenteral administration and patient monitoring.…”

Systemic Meglumine Antimoniate in Acute Cutaneous Leishmaniasis: Children versus Adults

“…5 Moreover, principals and methods that are being used for treating leishmaniasis in children are quite similar to those applied in adults. [6][7][8] Pentavalent antimony (Sb v ) drugs have been considered to be the first-line treatment of CL for over 50 years, 3 and still have high efficacy in the treatment of Old World CL. The improvement rate in endemic regions has been reported to be 17% for CL with L .…”

Thermotherapy in dermatologic infections

“…150 In a Greek report, cryotherapy has been added to low dose systemic antimonials to reduce the risk of adverse events secondary to antimonial therapy. 151 More recently, randomized controlled trials have been published that evaluate the efficacy of intralesional meglumine antimoniate, cryotherapy with a cotton applicator, and the combination of these modalities. In a 2004 randomized clinical trial performed in Iran, Asilian et al 70 reported that 120 of 132 lesions (90.9%) treated with combination cryotherapy and intralesional meglumine antimoniate were cured after one to three treatment sessions, whereas 120 of 210 lesions (57.15%) cleared with one to three sessions of cryotherapy alone, and 84 of 151 lesions (55.63%) cleared with one to three sessions of intralesional meglumine antimoniate alone.…”